What is Cellulite?

All humans have the same layers of skin in their body. In the area of buttocks and thighs, there is skin on the outside, subcutaneous fat underlying this and then a strong connective tissue called fascia that overlies the muscles. As with all things though, the more you look at these layers the more complex the reality is.

Between males and females, the skin itself is quite similar. However due to hormonal influences, male skin tends to be generally rougher and more hairy, and female skin is less hairy and much smoother. However there seems to be little in the very superficial skin layers that causes cellulite.

Under the skin or thermal layers, lie 2 layers of subcutaneous fat. These are separated in the buttock and thigh region by a very fine connective tissue layer called superficial fascia. Of course there are sex differences once again between males and females - which are hormonally controlled and also vary with age. As most of us are aware, men carry larger subcutaneous fat deposits around their abdomen (the beer belly or "love handles" when on the side of the lower abdomen), whereas women carry their subcutaneous fat on their buttocks and thighs. A certain amount of fat in these areas is completely normal, and indeed without it, it signifies an unhealthy hormonal profile and women are less attractive if less curvey or straight from waist to hips.

Although the womanly curves of buttocks and thighs is attractive, it tends to only be so if the curves are smooth. If the skin is dimpling, even perfect measurements look very unattractive. This is often referred to as the difference between a smooth curve or an "Orange Peel" or "Chesterfield couch" appearance.

This dimpled appearance is cellulite. However what causes it?

In the simple anatomical description above, what isn't mentioned is certain structures that run from the skin vertically deep down through the subcutaneous fat. These are called "fibrous septa". In normal people, these fibrous septa support the curvy shape of the female form - hence why males do not have them or certainly not to the same extent as females.

Unfortunately, in many females these septa pull on the skin causing dimpling where they attach to the skin, and allow the skin to bulge between these points. This gives a typical orange peel appearance of cellulite.

It is worth thinking of this as a mattress. The buttons on the mattress are the points where front and back are often connected together, whereas the bits in between have filling and therefore bulge outwards. You can imagine that the dimpling would worsen if there was more filling thus increasing the bulging, or if the buttons were pulled tighter pulling in these points.

This is exactly the same with cellulite. Putting on weight increases the filling of the subcutaneous fat, making the bulges look worse between the points being pulled inwards by the fibrous septa. In other people, even at normal weight, the fibrous septa pulled too tight cause a similar appearance.

It is thought that increased pressure in the areas of the bulging fat between the tightened fibrous septa can interrupt the normal blood supply, lymphatic supply and perhaps even nerve supply causing the area of cellulite to appear colder, occasionally a different colour from surrounding tissue and the skin to be duller and less shiny.

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